ArticleGut2021
Accuracy of a no-biopsy approach for the diagnosis of coeliac disease across different adult cohorts.
Article in Gut, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04788797 (Effect of the Endopeptidase AN-PEP on Gluten Exposure in Real Life in Celiac Disease Patients Treated With a Long-term Gluten-free Diet. Exploratory, Interventional, Prospective, Controlled and Double Blind Study), which is not on this map. Cited by 52 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Effect of the Endopeptidase AN-PEP on Gluten Exposure in Real Life in Celiac Disease Patients Treated With a Long-term Gluten-free Diet. Exploratory, Interventional, Prospective, Controlled and Double Blind Study
Who cites it
52 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- European Society for the Study of Coeliac Disease 2025 Updated Guidelines on the Diagnosis and Management of Coeliac Disease in Adults. Part 1: Diagnostic Approach.United European gastroenterology journal · 2025Guideline
- European Consensus on Malabsorption-UEG & SIGE, LGA, SPG, SRGH, CGS, ESPCG, EAGEN, ESPEN, and ESPGHAN. Part 1: Definitions, Clinical Phenotypes, and Diagnostic Testing for Malabsorption.United European gastroenterology journal · 2025Guideline
- Current guidelines for the management of celiac disease: A systematic review with comparative analysis.World journal of gastroenterology · 2022Pooled it
- Frequency of follow-up testing for tissue transglutaminase antibodies after initial positivity among children: An analysis of real-world data from a population-based cohort in Canada.Journal of the Canadian Association of Gastroenterology · 2026Article
- Presence of alarm symptoms at coeliac disease diagnosis is not associated with poorer long-term treatment outcomes.European journal of gastroenterology & hepatology · 2026Article
- Predictive Value of tTG-IgA ≥ 10×ULN for Villous Atrophy in a Romanian Adult Cohort: The Modifying Role of Smoking.Diagnostics (Basel, Switzerland) · 2026Article
- Artificial intelligence-augmented small bowel capsule endoscopy for coeliac disease: a literature review on accuracy, workflow, and safety.Translational gastroenterology and hepatology · 2026Review
- Challenges in the Pediatric Celiac Disease Diagnosis: An Up-to-Date Review.Diagnostics (Basel, Switzerland) · 2025Review
- Does Serum Anti-tissue Transglutaminase Level Predict Duodenal Histopathology and Clinical Manifestations of Celiac Disease in Adults?Middle East journal of digestive diseases · 2025Article
- Biopsy-Sparing Diagnosis of Coeliac Disease Based on Endomysial Antibody Testing and Clinical Risk Assessment.Alimentary pharmacology & therapeutics · 2025Article
- Patient preferences for the diagnosis of coeliac disease: A discrete choice experiment.United European gastroenterology journal · 2025Article
- Intestinal celiac disease - related autoantibodies.Frontiers in immunology · 2025Review
- Exploring Total Immunoglobulin A's Impact on Non-Biopsy Diagnosis of Celiac Disease: Implications for Diagnostic Accuracy.Nutrients · 2024Article
- Insights into coeliac disease diagnosis: a 2021-2023 overview of diagnostic approach and delays in children in Slovenia.Wiener medizinische Wochenschrift (1946) · 2024Article
- Non-biopsy Strategy for the Diagnosis of Celiac Disease in Adults: A Narrative Review.The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology · 2024Review
- Utilizing Telemedicine Applications in Celiac Disease and Other Gluten-Free-Diet-Dependent Conditions: Insights from the COVID-19 Pandemic.Healthcare (Basel, Switzerland) · 2024Review
- Guidelines for best practices in monitoring established coeliac disease in adult patients.Nature reviews. Gastroenterology & hepatology · 2024Review
- Feasibility of a "No-Biopsy" Approach for the Diagnosis of Celiac Disease in Symptomatic Adults.Cureus · 2024Article
- Cost-benefits and environmental impact of the no-biopsy approach for the diagnosis of coeliac disease in adults.Frontline gastroenterology · 2024Article
- Article
Corrections and comments
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Authors and funding
30 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveWe aimed to determine the predictive capacity and diagnostic yield of a 10-fold increase in serum IgA antitissue transglutaminase (tTG) antibody levels for detecting small intestinal injury diagnostic of coeliac disease (CD) in adult patients.
designThe study comprised three adult cohorts. Cohort 1: 740 patients assessed in the specialist CD clinic at a UK centre; cohort 2: 532 patients with low suspicion for CD referred for upper GI endoscopy at a UK centre; cohort 3: 145 patients with raised tTG titres from multiple international sites. Marsh 3 histology was used as a reference standard against which we determined the performance characteristics of an IgA tTG titre of ≥10×ULN for a diagnosis of CD.
resultsCohort 1: the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for IgA tTG levels of ≥10×ULN at identifying individuals with Marsh 3 lesions were 54.0%, 90.0%, 98.7% and 12.5%, respectively. Cohort 2: the sensitivity, specificity, PPV and NPV for IgA tTG levels of ≥10×ULN at identifying individuals with Marsh 3 lesions were 50.0%, 100.0%, 100.0% and 98.3%, respectively. Cohort 3: the sensitivity, specificity, PPV and NPV for IgA tTG levels of ≥10×ULN at identifying individuals with Marsh 3 lesions were 30.0%, 83.0%, 95.2% and 9.5%, respectively.
conclusionOur results show that IgA tTG titres of ≥10×ULN have a strong predictive value at identifying adults with intestinal changes diagnostic of CD. This study supports the use of a no-biopsy approach for the diagnosis of adult CD.
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